Gamified digital training tools for enhancing indirect vision skills in preclinical dental education: a randomized control trial

Abstract

Abstract Background Preclinical dental training emphasizes indirect vision using mirrors for precision and ergonomics to prevent musculoskeletal disorders. Students often face challenges with suboptimal posture and extended procedure times. Digital gamified tools like mobile app and ImageJ software enable objective and repeatable assessments, although targeted studies on indirect vision improvement remain limited. This randomized controlled trial evaluated the effectiveness of digital training in improving precision of performance and ergonomic posture during indirect vision tasks. Aim To assess the impact of gamified smartphone training on indirect vision skills in preclinical BDS students. Methods The aim of this study was to assess the impact of gamified smartphone training on indirect vision skills in preclinical BDS students. Parallel RCT at Manipal College of Dental Sciences, Mangalore ( n = 68 s-year BDS; control n = 34, intervention n = 34). Intervention group: Total 40 min, with each session 20-min with break Pac-Man 256 indirect mirror training on personal device. Both: Standardized phantom head cavity outline coloring. Outcomes: ImageJ % error (v1.54p), time (min), and modified CADEP score.Shapiro-Wilk test for normality and Mann-Whitney U test for group comparisons. Results 87.5% (14/16) of the variables were non-normal ( p < 0.05) in both groups. The training group showed reduced time, lower error, and superior CADEP scores compared to the controls ( p < 0.05). Conclusion Brief gamified digital training significantly improves indirect vision, efficiency, and ergonomics of dental students. Overall, gamified cellular device-based indirect vision training improved the accuracy of cavity preparation. We recommend low-cost integration into undergraduate curricula. Trial registration The study was Retrospectively registered with the Clinical Trials Registry - India (CTRI), CTRI Reg. Date 27/07/2026 with registration number CTRI/2026/07/114,792.